These questions are intended to determine whether the recipient recovered their immune function post-HCT. Along with hematopoietic recovery, the infused hematopoietic progenitor cells (HPCs) also generate a new immune system. This process may be slowed by immunosuppressants given to prevent GVHD.
Questions 64: Date sample collected:
Report the date when the most recent immunoglobulin sample was collected. If no immunoglobulin testing was performed during the reporting period, leave question 64 blank and override the validation error using the “Not Tested” option. Questions 69-74 will then be disabled.
Question 65: Did the recipient receive supplemental intravenous immunoglobulins (IVIG)?
IVIG is a product made from pooled human plasma and primarily contains IgG. It is used to provide immune-deficient recipients with antibody function to prevent infection. It may be administered intravenously or subcutaneously and IVIG given via either route should be reported in this section of the form.
Indicate whether the recipient received IVIG during the reporting period. If “yes,” continue with question 66. If “no,” continue with question 69.
Question 66: Was supplemental IVIG received in the 30 days prior to the date the sample was collected?
Indicate whether the recipient received IVIG ≤30 days prior to the immunoglobulin testing reported in questions 69-74. If IVIG is given within 30 days of immunoglobulin testing, the IgG level would not represent the recipient’s native IgG.
Question 67-68: Specify the indication for which IVIG was given:
Specify the indication(s) for which IVIG was given to the recipient. If the indication is unclear, consult with the transplant physician. If “other indication” is selected, specify the indication for use of IVIG in question 68.
Question 69-74: Specify the immunoglobulin values from the most recent testing:
Antibodies are produced by the immune system in response to foreign substances such as bacteria, viruses, or fungi. There are several types of immunoglobulins; the CIBMTR requests information on IgG, IgM, and IgA.
- IgG antibodies are present in all body fluids. They play a key role in fighting bacterial and viral infections.
- IgM antibodies are present in blood and lymph fluid. They are the first type of antibody produced by the immune system in response to an infection.
- IgA antibodies are present in the nose, airway, digestive tract, ears, eyes, saliva, tears, and blood. They protect surfaces of the body that are exposed to outside foreign substances.
If testing was performed as captured in question 64, report if the value for each immunoglobulin (antibody) is “known” or “unknown.” If “known,” specify the value and unit from the most recent test performed during the reporting period. Report “unknown” if testing was not performed during the reporting period or the results cannot be obtained.
Question 75-76: Were lymphocyte analyses performed?
Lymphocyte analyses are often performed post-HCT to evaluate the reconstitution of the immune system. Certain lymphocyte groups repopulate earlier than others post-HCT. Indicate whether lymphocyte analyses were performed. If “yes,” report the date the sample was collected in question 76. If “no,” continue with question 89.
For more information regarding reporting partial or unknown dates, see General Instructions, General Guidelines for Completing Forms.
Questions 77-88: Results of Lymphocyte Analysis
Report the value and specify the unit for each lymphocyte subset if known. If the subset was not tested on the date specified in question 76 or the result is not known, select “unknown” and continue with the next subset.
If the results show the absolute lymphocyte count, but only percentages of lymphocyte subsets, it is necessary to calculate the absolute value of each lymphocyte subset for reporting purposes. This can be done by multiplying the percentage of each subset by the absolute lymphocyte count. See the example below:
Example 1: Calculating lymphocyte counts
Absolute Lymphocyte Count: 4.8 × 109/L
|Phenotype||Lab Report Percentage||Calculation (Percentage x ALC)||Absolute Value|
|CD3||74%||0.74 × 4.8||CD3: 3.55× 109/L|
|CD3CD4||40%||0.40 × 4.8||CD4: 1.92 × 109/L|
|CD3CD8||34%||0.34 × 4.8||CD8: 1.63 × 109/L|
|Question Number||Date of Change||Add/Remove/Modify||Description||Reasoning (If applicable)|
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